Appeals at an All Time Low at Care to Care

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Care to Care’s appeal rate of 2% is among the lowest, if not the lowest in the benefit management industry, and has been for over ten years.

Care to Care, LLC

We have designed all of our systems to minimize the initial burden and nearly eliminate the need for appeals.

Care to Care’s appeal rate of 2% is among the lowest, if not the lowest in the benefit management industry, and has been for over ten years.

Care to Care, LLC is dedicated to improving care quality while reducing waste and offers referring physicians an opportunity to discuss possible adverse determinations with physicians board certified in fields appropriate to each request. In these discussions the Care to Care physician can explain why an adverse determination was anticipated, provide suggestions for more appropriate alternatives, or approve the request by gaining additional clinical information from the referrer. This process results in a very low rate of appeals, saving both the referrer and insurer time and money, while providing the patient (and referring doctor) with enhanced diagnostic efficiency.

The need to appeal contested denials makes the process of prior authorization inexcusably more arduous for the referring physicians. We have designed all of our systems to minimize the initial burden and nearly eliminate the need for appeals. Our data demonstrates that our process is successful in minimizing unnecessary appeals.

About Care to Care, LLC:
Care to Care is a URAC- Accredited Specialty Benefit Utilization Management company that delivers evidence-based, physician-friendly solutions to ensure payers and their beneficiaries receive cost-effective care by reducing redundant or unnecessary imaging studies. Care to Care, LLC provides Utilization and Network management to government, commercial, and self-funded programs. For more information, visit http://www.caretocare.com.

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Dmytro Arshynov
@CaretoCareRBM
since: 02/2010
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